The latest research into employee relations in the NHS has focused again on the problems with line managers.

The most common cause of workplace conflict was found to be line managers because of some heavy-handed practices and lack of communication skills, according to this year's report A critical reappraisal of the effectiveness of employee relations in the NHS.

Almost half of the senior HR managers interviewed said ‘improving line manager capabilities' was their number one priority for the coming year when it came to employee relations (up from 33% in 2022).

At the same time, the participants involved with the research — based on 211 responses and 33 in-depth interviews with HR leaders, senior staff and trade union reps — argued that the issues shouldn't be oversimplified: line managers aren't to blame in themselves. That's too easy a conclusion, and misleading.

The research, carried out by a team from iROWE (the Institute for Research into Organisations, Work and Employment) at the University of Central Lancashire (UCLan), suggests relationships between staff in the NHS in general have declined markedly since the same survey was carried out in 2022.

The major causes of conflict have remained the same: what's perceived as being ‘poor line management', as well as the usual challenges faced by workplaces around personal disagreements and relationship issues, bullying and issues of capability and performance. Meanwhile, the relationships between more senior management and staff have seen a slight improvement.

Digging into the realities beneath the headline figures, the interviewees highlighted the importance of the wider organisational context and culture. Line managers, it was accepted, were the staff who suffered most from the ‘pressure cooker' environment in the NHS. More than anyone else, their performance was scrutinised, they were under the most pressure in terms of balancing time they spend on operational duties with the day-to-day issues presented by people management. There were obvious limits in the support being given to them and the resources they had to work with — and ultimately there needed to be realistic expectations from senior managers and HR on what was possible.

Another, more hidden, consideration was found to be the way HR and line managers had been working together on employee relations. It was like a ‘tug of war', said interviewees, with line managers trying to shift problem cases over to HR and vice-versa. With so many operational issues to deal with, managers were often just looking for HR to tell them what to do.

So the actual conclusion from the research was that while line managers were central to better employee relations in the NHS — and for ensuring there's a more positive ‘no-blame' culture across organisations — change was dependent less on highlighting problems with line manager performance and more on how they can be supported.

The role of line managers in people management needs to be fully recognised and appreciated. And the individuals themselves need to be given the space and time to grow and flourish as people managers with specific and ongoing training and support from HR, as well as the autonomy to respond with informal approaches and solutions, and put real people skills into practice.

Most fundamentally, there has to be attention to job design and that critical balance between operational duties and managing people. This was still seen to be at the root of management issues in the NHS. Too many people were needing to climb up two career ladders at the same time, clinical on one side and management on the other. Clinicians were being promoted into operational roles in recognition of their technical abilities and then feeling stranded, finding that the support, relationships and collaboration on the people side wasn't there.

 Key recommendations in the report are for the NHS to change its approach to succession planning, identifying more future managers on the basis of people skills; also, making sure there are regular opportunities for managers at all levels to refine their capabilities — ahead of  promotion as well as while they are in a post involving line management — and not promoting staff because they are ‘next in line' or just because of technical competence.

In turn, a more strategic approach to selection and development, rooted in people skills, will lead to more confidence in dealing with employee relations, better role models and sharing of good practice. And that's important for everyone, working anywhere in the system, because it's the basis of good employee relations, where issues are picked up early and there can be win-win solutions, and a good work culture.